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Evidence Level as Used in Nursing Discussion Evidence Level as Used in Nursing Discussion Evidence Level as Used in Nursing Discussion   Describe the “levels of evidence” and provide an example of the type of practice change that could result from each. The levels of evidence were originally described in a report by the Canadian Task Force on the Periodic Health Examination in 1979.7 The report’s purpose was to develop recommendations on the periodic health exam and base those recommendations on evidence in the medical literature. The authors developed a system of rating evidence (Table 1) when determining the effectiveness of a particular intervention. The evidence was taken into account when grading recommendations. For example, a Grade A recommendation was given if there was good evidence to support a recommendation that a condition be included in the periodic health exam. The levels of evidence were further described and expanded by Sackett8 in an article on levels of evidence for antithrombotic agents in 1989 (Table 2). Both systems place randomized controlled trials (RCT) at the highest level and case series or expert opinions at the lowest level. The hierarchies rank studies according to the probability of bias. RCTs are given the highest level because they are designed to be unbiased and have less risk of systematic errors. For example, by randomly allocating subjects to two or more treatment groups, these types of studies also randomize confounding factors that may bias results. A case series or expert opinion is often biased by the author’s experience or opinions and there is no control of confounding factors. Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: Evidence Level as Used in Nursing Discussion As the name suggests, evidence-based medicine (EBM), is about finding evidence and using that evidence to make clinical decisions. A cornerstone of EBM is the hierarchical system of classifying evidence. This hierarchy is known as the levels of evidence. Physicians are encouraged to find the highest level of evidence to answer clinical questions. Several papers published in Plastic Surgery journals concerning EBM topics have touched on this subject.1–6 Specifically, previous papers have discussed the lack of higher level evidence in PRS and need to improve the evidence published in the journal. Before that can be accomplished, it is important to understand the history behind the levels and how they should be interpreted. This paper will focus on the origin of levels of evidence, their relevance to the EBM movement and the implications for the field of plastic surgery as well as the everyday practice of plastic surgery.   Order Now